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Active, not recruitingNCT04365374ClinicalTrials.gov record

Post-Surgical Stereotactic Radiotherapy (SRT) Versus GammaTile-ROADS (Radiation One and Done Study)

Brain Metastases

THE QUICK READ

What this study involves

The registry does not currently label this study as recruiting. Ask about its status before planning a screening visit.

Study type
Interventional
Phase
Phase 3
Age range
18 years - Not specified
Sex eligible
All sexes
Healthy volunteers
Not accepted
Participants
230 Estimated

These are starting points, not an eligibility decision. The research team must review the full requirements.

About the research

This trial will be a randomized controlled study comparing the efficacy and safety of intraoperative radiation therapy using GammaTilesTM (GT) versus SRT 3-4 weeks following metastatic tumor resection which is the current standard of care.

Read the full description

GammaTile therapy results in improved clinical outcomes; however, the data is a single site experience with a limited number of subjects, including only 12 of which were patients with metastatic brain tumors. The primary objective of this randomized, controlled trial is to compare the efficacy and safety of intraoperative radiation therapy using GammaTile® (GT) versus SRT 3-4 weeks following metastatic tumor resection which is the current standard of care. The data collected in this trial design will allow for a direct comparison of a variety of outcomes including local control, overall survival, functional status, quality of life, neurocognitive status, and safety in the target population. In order to support direct comparisons, subjects will be randomized to the two equally sized arms (1:1) based on the following stratification factors: age (\<60 vs ≥60), duration of extracranial disease control (≤3 months vs \>3 months), number of metastases (one, 2-4 total, 5-6 total ), histology (breast cancer, lung cancer, melanoma, other), the maximal diameter of the index lesion (≤3 cm, \>3 cm to ≤5cm, \>5cm to ≤7cm) and use of prior or current immunotherapy (yes vs no).

An index lesion meeting the criteria of ≥ 2.0-7.0 cm in maximum diameter and appropriate for gross total resection (GTR), will be identified and up to five (5) other unresected, previously untreated lesions in a patient will be allowed. After resection of the index lesion, the surgical bed will be treated with adjunct radiation (either GT or SRT) thereby following the standard of care guidelines (NCCN Guidelines, 2019). Additionally, all unresected, previously untreated metastatic lesions will be treated with stereotactic radiosurgery alone, which also adheres to standard of care guidelines (NCCN Guidelines, 2019).

GammaTile is an FDA-cleared means of rapid dose delivery of radiation therapy directly to the tumor bed with predictable dosimetry at the immediate time of resection, and an intense but localized radiation treatment may confer a reduced risk for radiation necrosis compared to other therapies. It is typically easily placed with minimal additional operative time and limited staff radiation exposure.

Given these benefits, the rationale for conducting this randomized controlled comparison study is to generate additional data, to further support the use of this new FDA-cleared method of delivering radiation therapy in the setting of newly diagnosed brain metastases.

Who may be able to participate?

The list below is the sponsor’s full registry wording. It can include conditions, prior treatment, test results and other requirements. A match in search does not mean you qualify.

Inclusion Criteria:

1. Patients aged 18 years old and above. Eligibility is restricted to this age group given that the battery of neurocognitive tests utilized in this protocol are not developed or validated for use in a younger population.
2. One to six newly diagnosed brain metastases, identified on the screening MRI, from an extracranial primary tumor.
3. Only one lesion, designated the index lesion, is planned for surgical resection. The index lesion must be between 2.0 and 7.0 cm in maximal extent on the screening MRI, and gross total resection is expected by the neurosurgeon.
4. Non-index lesions must measure ≤ 4.0 cm in maximal extent on the screening MRI brain scan. The unresected lesions will be treated with SRT as outlined in the treatment section of the concept.
5. All metastases must be located ≥ 5 mm from the optic chiasm and outside the brainstem. Dural based metastasis are eligible.
6. Previous and/or concurrent treatment with investigational or FDA approved systemic therapies (e.g., chemotherapy, targeted therapeutics, immunotherapy) are permitted and must follow protocol guidelines as follows: Systemic therapy is allowed a minimum of one week from last systemic therapy cycle to surgical resection, and one week after surgical resection to allow a minimum of one week before starting/resuming systemic therapy, depending on the specific systemic agent(s), as recommended by medical/neuro-oncology. Systemic therapy is not allowed 1 day before SRT, the same day as the SRT, or 1 day after the completion of the SRT or longer, depending on the specific systemic agent(s), as recommended by medical/neuro-oncology. Agents that are delivered by implant or depot injections (such as hormonal therapies) are excluded from these restrictions.
7. Karnofsky Performance Scale (KPS) score of ≥ 70. Patients with KPS \< 70 can be enrolled if their baseline KPS within 14 days of screening was estimated ≥ 70 and surgical management is expected to improve KPS to ≥ 70.
8. Stable systemic disease or reasonable systemic treatment options predicting a life expectancy of ≥6 months.
9. Ability to complete an MRI of the head with contrast
10. Adequate renal and hepatic function to undergo surgery, in investigators opinion.
11. For women of childbearing potential only, a negative urine or serum pregnancy test done \<7 days prior to randomization is required. Women must be willing to notify investigator immediately if they become pregnant at any time during the trial period.
12. Men and women of childbearing potential must be willing to employ adequate contraception throughout the study and for men for up to 3 months after completing treatment.
13. Subjects must be fluent in English, Spanish, or another language the study site is prepared to obtain informed consent for in this trial. English speaking subjects will complete Neurocognitive assessments. Non-English-speaking subjects are trial-eligible but will not complete the Neurocognitive assessments as the psychometric properties for translated tests are either not known or not as robust.
14. Willingness and ability to provide written informed consent and HIPAA authorization prior to performance of any study-related procedures. A legally authorized representative may provide consent if the potential subject lacks the capacity to provide consent themselves.

Exclusion Criteria

1. Age \<18 years.
2. Karnofsky Performance Scale (KPS) score of \<70. Patients with KPS \< 70 can be enrolled if their baseline KPS within 14 days of screening was estimated ≥ 70 and surgical management is expected to improve KPS to ≥ 70.
3. Sensitivity to bovine (cow) derived materials including collagen products.
4. Past radiation or surgical therapy to the index lesion or the newly diagnosed non-index lesion(s) is exclusionary. However, up to a total of 2 prior courses of SRT treatment to previously diagnosed lesions are allowed as long as any treated lesions are were ≥15mm from the index lesion.
5. Patients with \>6 newly diagnosed metastases on screening MRI
6. Pregnant patients.
7. Primary germ cell tumor, small cell carcinoma, or lymphoma.
8. Leptomeningeal metastasis (LMD). Note: For the purposes of exclusion, LMD is a clinical diagnosis, defined as radiologic or clinical evidence of leptomeningeal involvement with or without positive cerebrospinal fluid (CSF) cytology.
9. Prior WBRT for brain metastases.
10. Concomitant therapy that, in the investigator's opinion, would interfere with the evaluation of the safety or efficacy of the study device.
11. Comorbid psychiatric or neurologic disease or injury impacting cognition, in the opinion of the treating physician, that might impair patient's ability to understand or comply with the requirements of the study or to provide consent
12. Subjects who, in the investigator's opinion, are unable to understand the protocol or to give informed consent, have a history of poor cooperation, noncompliance with medical treatment, or difficulty in returning for follow up care. A legally authorized representative may provide consent if the potential subject lacks the capacity to provide consent themselves.

Understand screening

Treatment, groups and participation

The registry may describe treatments and study duration without a complete visit calendar. Ask the study team for the exact schedule, procedures, risks, costs and alternatives. Keep your usual care plan unless your treating clinician tells you otherwise.

Assignment
Random assignment
Masking
Single masked
Surgical Resection and GammaTile Therapy

Surgical Resection and GammaTile Therapy

Device: Gamma Tile-Surgically Targeted Radiation Therapy (STaRT)

Surgical Resection and Stereotactic Radiation Therapy

Surgical Resection and Stereotactic Radiation Therapy

Radiation: Stereotactic Radiation Therapy

Gamma Tile-Surgically Targeted Radiation Therapy (STaRT) DEVICE

GammaTiles are a permanently implanted radiation device consisting of Cs-131 seeds positioned within a collagen tile

Stereotactic Radiation Therapy RADIATION

External Beam Radiation Therapy

Prepare your questions

What researchers are measuring

Outcome measures describe what is being studied. They are not proof that a treatment works.

Primary measures

Surgical bed recurrence-free survival (SB-RFS) from the time of randomization up to 2 years post radiation.

Time frame: up to 2 years post-radiation

Surgical bed control is defined as the absence of new nodular contrast enhancement in the index lesion surgical bed.

Secondary measures

Overall Survival

Time frame: up to 3 years

Survival of subjects

Functional Assessment of Cancer Therapy-Brain (FACT-Br)

Time frame: up to 9 months

An assessment of quality of life (QOL)

Linear Analog Scale Assessments (LASA)

Time frame: up to 9 months

An assessment of quality of life (QOL)

Hopkins Verbal Learning Test (HVLT-R)

Time frame: up to 24 months

An assessment of neurocognitive status

Controlled Oral Word Association Test (COWAT)

Time frame: up to 24 months

An assessment of neurocognitive status

Trail Making Tests (TMT) Parts A and B

Time frame: up to 24 months

An assessment of neurocognitive status

Barthel ADL

Time frame: up to 24 months

An assessment of physical functioning status

No results are flagged as posted.

Review the complete result tables and limitations in the official record.

Open official results ↗

Research locations (37)

The overall study status and a local site’s status can differ. Confirm that location’s availability before traveling.

37 locations

HonorHeath Scottsdale Osborn Medical CenterPhoenix, Arizona, United StatesStatus unknown
University of Arkansas Medical CenterLittle Rock, Arkansas, United StatesStatus unknown
Ascension St. Vincent's- RiversideJacksonville, Florida, United StatesStatus unknown
Baptist MD Anderson Cancer Center- JacksonvilleJacksonville, Florida, United StatesStatus unknown
HCA Florida First Coast Neurology- Orange ParkOrange Park, Florida, United StatesStatus unknown
Advent health OrlandoOrlando, Florida, United StatesStatus unknown
Orlando HealthOrlando, Florida, United StatesStatus unknown
Florida Health Sciences Center, Inc. d/b/a Tampa General HospitalTampa, Florida, United StatesStatus unknown
Piedmont HospitalAtlanta, Georgia, United StatesStatus unknown
Winship Cancer Institute of Emory UniversityAtlanta, Georgia, United StatesStatus unknown
RUSH UniversityChicago, Illinois, United StatesStatus unknown
Indiana University, IU Health Methodist HospitalIndianapolis, Indiana, United StatesStatus unknown
The University Of Kansas Cancer CenterKansas City, Kansas, United StatesStatus unknown
University of LouisvilleLouisville, Kentucky, United StatesStatus unknown
Henry Ford HealthDetroit, Michigan, United StatesStatus unknown
Abbott Northwestern HospitalMinneapolis, Minnesota, United StatesStatus unknown
University Of MinnesotaMinneapolis, Minnesota, United StatesStatus unknown
Ellis Fischel Cancer Center at University of MissouriColumbia, Missouri, United StatesStatus unknown
SSM Health Saint Louis University HospitalSt Louis, Missouri, United StatesStatus unknown
Dartmouth-HitchcockLebanon, New Hampshire, United StatesStatus unknown
HMH Jersey Shore University Medical CenterNeptune City, New Jersey, United StatesStatus unknown
Albany Medical CenterAlbany, New York, United StatesStatus unknown
Memorial Sloan KetteringNew York, New York, United StatesStatus unknown
Westchester Medical CenterWestchester, New York, United StatesStatus unknown
University of North Carolina HealthChapel Hill, North Carolina, United StatesStatus unknown
ECU HealthGreenville, North Carolina, United StatesStatus unknown
Mayfield Brain and SpineCincinnati, Ohio, United StatesStatus unknown
Allegheny Health NetworkPittsburgh, Pennsylvania, United StatesStatus unknown
Brown University HealthProvidence, Rhode Island, United StatesStatus unknown
Vanderbilt University Medical CenterNashville, Tennessee, United StatesStatus unknown
UT Southwestern Simmons Cancer CenterDallas, Texas, United StatesStatus unknown
Baylor St. Luke's Medical Center | Baylor College of MedicineHouston, Texas, United StatesStatus unknown
Houston MethodistHouston, Texas, United StatesStatus unknown
The University of Texas M. D. Anderson Cancer CenterHouston, Texas, United StatesStatus unknown
UT Health San AntonioSan Antonio, Texas, United StatesStatus unknown
SCRI with Texas OncologyThe Woodlands, Texas, United StatesStatus unknown
Virginia MasonSeattle, Washington, United StatesStatus unknown

Study team and timeline

Lead sponsor
GT Medical Technologies, Inc.
Study start
Apr 6, 2021 Actual
Primary completion
Aug 30, 2029 Estimated
Study completion
Aug 30, 2029 Estimated
First posted
Apr 28, 2020 Actual
Last updated
Nov 10, 2026 Actual

Official study contacts

No central contact is listed. Check the locations and the official record.

Official study title

A Phase 3 Randomized Controlled Trial of Post-Surgical Stereotactic Radiotherapy (SRT) Versus Surgically Targeted Radiation Therapy (STaRT) With Gamma Tile for Treatment of Newly Diagnosed Metastatic Brain Tumors.

A HUMAN NEXT STEP

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Source: ClinicalTrials.gov API v2. Information is submitted by sponsors and investigators. NLM does not approve the safety or science of all listed studies. Registry disclaimer.

Retrieved: Nov 12, 2026 · Last registry update: Nov 10, 2026